Care in Northern Ireland: free home help over 75, the Trusts and care home charges

Two differences matter most for care at home. The first is who you deal with. In England the council runs social care and the NHS is separate; in Northern Ireland both sit inside the same Trust, so the district nurse and the social worker work for the same organisation. The second is the charge. In England help at home is means-tested at every age. In Northern Ireland the Trust's home help service is free from the age of 75.

For care homes the savings limits are the same figures as England's. The weekly allowance your relative keeps, and the payment towards nursing care, are set separately.

Most of the guides on this site describe England. Our pages on how council funding works, the council's care needs assessment and financial assessment and direct payments set out the English process, so read them as background and use this page for anything with a figure in it. If your family also has a relative elsewhere in the UK, care funding in Scotland and care funding in Wales cover the other two sets of rules.

1. 1

   Contact the Trust's social services team

   The first step

   Ring the Trust that covers your relative's address and ask for an assessment of need. You can ask on their behalf, from England. The GP, a district nurse or a hospital ward can also refer them.
2. 2

   The assessment of need

   Free, whatever their savings

   A social worker, nurse or occupational therapist talks with your relative about what they can and cannot do safely, and what matters to them. Money is not part of this conversation. The Department of Health says finances should never be a reason to refuse an assessment.
3. 3

   A care plan, and somebody to coordinate it

   If help is agreed

   The Trust writes a care plan setting out the support. Where needs are more complex, a named professional coordinates it. The Department's guidance calls this person a case manager, and it also uses the names care manager and key worker.
4. 4

   Reviews

   As set out in the plan

   The care plan should be reviewed at the times it sets out, and at any other time needs change. If your relative gets worse, ring the Trust and ask for a reassessment rather than waiting for the next review.
5. 5

   If you disagree

   Complaint, then the Ombudsman

   Raise it with the Trust first, and use its complaints procedure if that does not settle it. After the Trust's final answer you can go to the Northern Ireland Public Services Ombudsman. The Patient and Client Council gives free help to make a complaint.

When you ring, describe a bad day rather than a good one. Say what your relative cannot do safely on their own and what has gone wrong when nobody was there. The Department of Health's guidance says the coordinator is most likely to be a nurse where health needs come first, and a social worker where social care needs do. Write down the name and phone number of the person coordinating your relative's care and keep it by the phone.

nidirect explains how health and social care assessments work and lists the contact details for every Trust. Its page on how to complain about health and social care sets out the time limits.

The age rule means a relative who is 75 or over will not pay for the Trust's home help, whatever they have saved and whether or not they own their home. That is the largest single difference from England, where the council's charges for care at home are means-tested at any age. The help still has limits: the circular says the service runs within an annual budget and published criteria, so what your relative gets depends on the assessment of need and the Trust's priorities.

Some services sit outside the home help rules. nidirect says there is normally a charge for meals delivered at home, and Alzheimer's Society's guide on care assessments and charges in Northern Ireland says meals can be charged at a flat rate rather than by a means test. Ask the Trust which services in the care plan carry a charge, and ask for it in writing.

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If a Trust does charge for home help, the Department's model scheme works the charge out from income:

• Attendance Allowance, Disability Living Allowance and the home your relative lives in are ignored.
• Where your relative or their partner is 60 or over, the first £6,000 of savings is ignored, and every £250 above it counts as £1 a week of income.
• If the charge works out at £3.00 a week or less, nothing is charged, and nobody pays more than the service costs.

The full scheme is in the Department of Health's home help and domiciliary care guidance. If you are asked to pay, ask the Trust to show you the calculation.

The Department of Health decided in March 2026 to keep the capital limits at £14,250 and £23,250 for 2026/27, the same figures England uses. The personal expenses allowance rose to £36.62 a week from 6 April 2026. The circular says this money is your relative's to spend as they wish, and nobody should pressure them to spend it in a particular way. nidirect's page on care home fees still showed the earlier figure of £34.10 when we checked; the Department's circular is the one to rely on.

The nursing payment works in a similar way to NHS-funded nursing care in England. For a resident paying their own fees, the Trust pays it straight to the home, so it appears as a reduction in the bill. It depends on the Trust assessing your relative as needing nursing care, so ask for that assessment when they move in. Our page on funded nursing care describes the English scheme.

The Trust arranges a home that meets your relative's needs, and your relative can choose a more expensive one if a relative or friend pays the difference, as a third-party contribution. Our guide to care home top-up fees explains how that works in England, and the idea is the same. England also has a statutory deferred payment scheme, described in deferred payment agreements. We have not found an equivalent scheme in the Northern Ireland guidance, so ask the Trust how it handles a house that has not yet been sold.

A direct payment gives the most choice over who the carer is and when they come. It also brings the most paperwork: keeping records, and, if you employ somebody directly, the duties of an employer. nidirect says the Trust decides how much the payment is, based on the support your relative needs, that it must be spent on the services or equipment in the assessment and care plan, and that it does not affect other benefits. A managed budget suits families who want to choose but not hold the money.

Paying a family member is restricted. The Northern Ireland direct payments regulations of 2004 say a direct payment cannot be used to pay a husband, wife or partner, or a close relative who lives in the same household, unless the Trust is satisfied that it is necessary to meet the person's needs. A relative who lives elsewhere is not covered by that rule, although the Trust can set other conditions. Our guide can my mum pay me to care for her? describes the English rules. Direct payments for care on nidirect sets out how to ask for one.

1. 1

   Attendance Allowance

   £76.70 or £114.60 a week

   For people over State Pension age who need help with personal care or supervision. Not means-tested, and paid by the Department for Communities through its Disability and Carers Service.
2. 2

   Personal Independence Payment

   Under State Pension age

   For people aged 16 or over who have not reached State Pension age. The Department for Communities runs it from its PIP Centre.
3. 3

   Carer's Allowance

   £86.45 a week

   For a family carer spending at least 35 hours a week caring and earning £204 a week or less after deductions. Paid by the Department for Communities through the Disability and Carers Service.
4. 4

   Enduring Power of Attorney

   Money and property only

   The document that lets somebody manage your relative's money and property. It is registered with the Office of Care and Protection at the High Court once your relative is becoming unable to manage.

Claim the benefits through nidirect rather than gov.uk: see Attendance Allowance, Personal Independence Payment and Carer's Allowance on nidirect. Our guides to Attendance Allowance, PIP and Carer's Allowance describe the same benefits as they are claimed in England, and the advice on filling in the forms applies in both places. The Trust's home help charge ignores Attendance Allowance, so claiming it does not raise that charge.

Power of attorney needs more care. nidirect says an Enduring Power of Attorney in Northern Ireland covers financial matters only, so it does not let the attorney make decisions about your relative's care or treatment. It only has to be registered when the attorney believes your relative is becoming unable to manage their affairs. An English Lasting Power of Attorney is a different document under different law.

The Mental Capacity Act (Northern Ireland) 2016 will change this, but it has been brought in only in part. The Department of Health says the parts on deprivation of liberty, and on money and valuables in hospitals and care homes, came into force on 2 December 2019. Lasting powers of attorney are not among the parts in force, so the Enduring Power of Attorney remains the document to make. Alzheimer's Society explains that if your relative can no longer make one, somebody may have to apply to the Office of Care and Protection to become a controller instead. Read managing your affairs and Enduring Power of Attorney on nidirect, and ask a solicitor in Northern Ireland to draw it up while your relative can still sign. Our guide to the Lasting Power of Attorney describes the English system.